Medical device rotation assemblies and methods of using the same

ABSTRACT

A medical device that includes a sheath, a tool within the sheath and movable relative to the sheath, and a handle including a rotation assembly configured to rotate the tool relative to the sheath in response to rotation of the rotation assembly relative to a portion of the handle. The rotation assembly rotates the tool relative to the sheath at predefined angular intervals and inhibits movement at each of the predefined angular intervals.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of priority from U.S. ProvisionalApplication No. 62/969,881, filed Feb. 4, 2020, which is incorporated byreference herein in its entirety.

TECHNICAL FIELD

Various aspects of the disclosure relate generally to medical systems,devices, and related methods. At least certain examples of thedisclosure relate to systems, devices, and related methods for indexingand controlling a position of one or more medical devices within apatient during a procedure, among other aspects.

BACKGROUND

Technological developments have given users of medical systems, devices,and methods, the ability to conduct increasingly complex procedures onsubjects. One challenge in the field of minimally invasive surgeriessuch as endoscopy, laparoscopy, and thoracoscopy, among other surgicalprocedures, is associated with providing control of medical devices withrespect to an orientation and position of such devices during aprocedure. Placement of such medical devices within a patient may bedifficult. Additionally, maintaining a desired position of a device isunreliable. The limitations on medical devices that facilitate access ofother devices into a patient for placement may prolong the procedure,limit its effectiveness, and/or cause injury to the patient due todevice failure or breakage.

SUMMARY

Aspects of the disclosure relate to, among other things, systems,devices, and methods for accessing a target treatment site with amedical apparatus having features that facilitate positioning of theapparatus, among other aspects. Each of the aspects disclosed herein mayinclude one or more of the features described in connection with any ofthe other disclosed aspects.

According to an example, a medical device includes a sheath, a toolwithin the sheath and movable relative to the sheath, and a handleincluding a rotation assembly configured to rotate the tool relative tothe sheath in response to rotation of the rotation assembly relative toa portion of the handle. The rotation assembly rotates the tool relativeto the sheath at predefined angular intervals and inhibits movement ateach of the predefined angular intervals.

Any of the medical devices described herein may have any of thefollowing features. The rotation assembly maintains the tool in the atleast one of the predefined angular intervals to fix the tool relativeto the sheath. The rotation assembly releases the tool from the at leastone of the predefined angular intervals in response to predeterminedrotational force applied to the rotation assembly. The rotation assemblygenerates at least one of a tactile, audible, or visual feedback as therotation assembly rotates between the predefined angular intervals. Therotation assembly includes a shaft having a plurality of ridges thatcircumferentially alternate with a plurality of recesses. The handleincludes one or more arms. Each of the one or more arms is configured toengage the plurality of ridges and the plurality of recesses. Therotation assembly inhibits rotational movement between the rotationassembly and the portion of the handle, when a first arm of the one ormore arms is positioned in a first recess of the plurality of recesses.While the first arm is positioned in the first recess, application of arotational force onto the rotation assembly relative to the portion ofthe handle causes the first arm to exit the first recess, and causes thefirst arm to be positioned in a second recess circumferentially adjacentto the first recess. The one or more arms includes a plurality of armsextending radially inward into a lumen of the handle. Each of theplurality of arms is offset from each of the other plurality of arms.The rotation assembly includes a plurality of recesses or aperturesdisposed in an outer surface of the rotation assembly. The handleincludes one or more detents configured to engage the plurality ofrecesses or apertures. The rotation assembly inhibits rotationalmovement between the rotation assembly and the portion of the handle,when a first detent of the one or more detents is positioned in a firstrecess or aperture of the plurality of recesses or apertures. The firstdetent includes a compressible portion. While the first detent ispositioned in the first recess or aperture, application of a rotationalforce to the rotation assembly relative to the portion of the handlecauses the first detent to compress and exit the first recess, andcauses the first detent to be positioned in a second recess or aperturecircumferentially adjacent to the first recess or aperture. The rotationassembly includes a distally-facing flange, wherein a protrusion extendsdistally from the distally-facing flange. The handle includes aproximally-facing flange having a plurality of circumferentially spacedapart recesses or apertures. The protrusion is configured to be receivedby each of the plurality of recesses or apertures, such that when theprotrusion is received by one of the plurality of recesses or apertures,rotational movement between the rotating member and the portion of thehandle is inhibited. The medical device further including a deformablemember disposed proximally of the distally-facing flange. The deformablemember biases the distally-facing flange toward the proximally-facingflange. While the protrusion is positioned in a first recess oraperture, application of a rotational force to the rotation assemblyrelative to the portion of the handle causes the deformable member tocompress, causes the protrusion to exit the first recess or aperture,and causes the protrusion to be positioned in a second recess oraperture circumferentially adjacent to the first recess or aperture. Theprotrusion includes a compressible portion. While the protrusion ispositioned in the first recess or aperture, application of a rotationalforce to the rotation assembly relative to the portion of the handlecauses the protrusion to compress and exit the first recess or aperture,and causes the protrusion to be positioned in a second recess oraperture circumferentially adjacent to the first recess or aperture. Thehandle includes a plurality of protrusions and a plurality of recesses.The plurality of protrusions and the plurality of recesses alternatewith one another. The rotation assembly includes a compressible member.The compressible member is configured to be received by each of theplurality of recesses, such that when the protrusion is received by oneof the plurality of recesses, rotational movement between the rotationassembly and the portion of the handle is inhibited. The rotationassembly includes a flange, the flange having a slot enclosed by theflange. The compressible member includes a periphery of the flangedefining at least a portion of the slot. While the compressible memberis positioned in a first recess, application of a rotational force tothe rotation assembly relative to the portion of the handle causes thecompressible member to compress radially inward while reducing a volumeof the slot, causes the compressible member to exit the first recess,and causes the compressible member to be positioned in a second recesscircumferentially adjacent to the first recess or aperture.

According to another example, a medical device includes a handleincluding a rotation assembly that is movable relative to a remainder ofthe handle, a sheath extending from the handle, and a tool within thesheath and movable relative to the sheath. The rotation assembly rotatesthe tool to a plurality of predefined angular positions relative to thesheath in response to rotation of the rotation assembly relative to atleast a portion of the handle. The rotation assembly provides at leastone of a tactile feedback or audible feedback to a user as the rotationassembly rotates from one of the plurality of predefined angularpositions to another of the plurality of predefined angular positions.

Any of the medical devices described herein may have any of thefollowing features. The rotation assembly maintains the tool in the atleast one of the predefined angular positions to fix the tool relativeto the sheath. The rotation assembly releases the tool from the at leastone of the predefined angular positions in response to predeterminedrotational force applied to the rotation assembly. The rotation assemblygenerates at least one of a tactile, audible, or visual feedback as therotation assembly rotates between the predefined angular positions. Therotation assembly includes a shaft having a plurality of ridges thatcircumferentially alternate with a plurality of recesses. The handleincludes one or more arms. Each of the one or more arms is configured toengage the plurality of ridges and the plurality of recesses. Therotation assembly inhibits rotational movement between the rotationassembly and the portion of the handle, when a first arm of the one ormore arms is positioned in a first recess of the plurality of recesses.

According to another example, a method of rotating a tool relative to asheath to a plurality of predefined angular positions includes rotatingan assembly relative to a handle away from a first predefined angularposition to a second predefine angular position. The method includesgenerating a first indexing feedback at the rotation assembly inresponse to rotating the rotation assembly out of the first predefinedangular interval, and generating a second indexing feedback at therotation assembly in response to rotating the rotation assembly into thesecond predefined angular position. The first predefined angularposition is configured to maintain the tool at a first fixed orientationrelative to the sheath, and the second predefined angular position isconfigured to maintain the tool at a second fixed orientation relativeto the sheath.

It may be understood that both the foregoing general description and thefollowing detailed description are exemplary and explanatory only andare not restrictive of the invention, as claimed.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are incorporated in and constitute apart of this specification, illustrate exemplary aspects of thedisclosure and together with the description, serve to explain theprinciples of the disclosure.

FIG. 1A is a side view of an exemplary medical system including amedical device and a medical instrument, with the medical device havinga rotation assembly, according to aspects of this disclosure;

FIG. 1B is a cross-sectional side view of the medical instrument of FIG.1 , with the medical instrument including a needle in an extended state,according to aspects of this disclosure;

FIG. 10 is a cross-sectional side view of the medical instrument of FIG.1 , with the medical instrument including a cannula in an extendedstate, according to aspects of this disclosure;

FIG. 2 is an exploded view of the rotation assembly of FIG. 1 ,according to aspects of this disclosure;

FIG. 3 is a bottom view of the rotation assembly of FIG. 1 , accordingto aspects of this disclosure;

FIG. 4 is an exploded view of another exemplary rotation assembly of themedical device of FIG. 1 , according to aspects of this disclosure;

FIG. 5 is an exploded view of another exemplary rotation assembly of themedical device of FIG. 1 , according to aspects of this disclosure;

FIG. 6 is a cross-sectional view of the rotation assembly of FIG. 5 ,according to aspects of this disclosure;

FIG. 7 is a perspective view of another exemplary rotation assembly ofthe medical device of FIG. 1 , according to aspects of this disclosure;

FIG. 8 is a side view of the rotation assembly of FIG. 7 , according toaspects of this disclosure;

FIG. 9 is a cross-sectional view of the rotation assembly of FIG. 8 ,according to aspects of this disclosure;

FIG. 10 is a side view of another exemplary rotation assembly of themedical device of FIG. 1 , according to aspects of this disclosure;

FIG. 11 is a cross-sectional view of the rotation assembly of FIG. 10 ,according to aspects of this disclosure;

FIG. 12 is an exploded side view of another rotation assembly of themedical device of FIG. 1 , according to aspects of this disclosure;

FIG. 13 is a bottom view of the rotation assembly of FIG. 12 , accordingto aspects of this disclosure; and

FIG. 14 is a cross-sectional view of the rotation assembly of FIG. 12 ,according to aspects of this disclosure.

DETAILED DESCRIPTION

Examples of the disclosure include systems, devices, and methods forindexing a position and/or orientation of multiple components of amedical instrument at a target site within the body, among otheraspects. Reference will now be made in detail to aspects of thedisclosure, examples of which are illustrated in the accompanyingdrawings. Wherever possible, the same or similar reference numbers willbe used through the drawings to refer to the same or like parts. Theterm “distal” refers to a portion farthest away from a user whenintroducing a device into a patient. By contrast, the term “proximal”refers to a portion closest to the user when placing the device into thepatient. As used herein, the terms “comprises,” “comprising,” or anyother variation thereof, are intended to cover a non-exclusiveinclusion, such that a process, method, article, or apparatus thatcomprises a list of elements does not necessarily include only thoseelements, but may include other elements not expressly listed orinherent to such process, method, article, or apparatus. The term“exemplary” is used in the sense of “example,” rather than “ideal.” Asused herein, the terms “about,” “substantially,” and “approximately,”indicate a range of values within +/−10% of a stated value.

Examples of the disclosure may be used to facilitate control of aposition and orientation of tools/devices of a medical instrument at atarget treatment site by providing one or more mechanisms and/orassemblies for indexing movement of said tools/devices. For example,some examples combine a rotation assembly on a medical device forselective control and/or manipulation of components of a medicalinstrument received within the medical device to a plurality ofpredefined angular intervals/positions. The rotation assembly may beconfigured to control the radial orientation of a distal end of amedical instrument. The medical device may include a body that defines alumen configured to receive the medical instrument therein, and arotation assembly coupled to the medical instrument for moving themedical instrument within the lumen of the body. The medical instrumentmay include a sheath and a tool disposed within the sheath, such as, forexample, an access cannula. The rotation assembly may be positionedexternal to the body and coupled to the tool of the medical instrumentwithin the lumen, such that a position and orientation of the tool maybe indexed relative to the body in response to actuation of the rotationassembly. The rotation assembly of the medical device may furtherprovide selective control and/or manipulation of components of themedical device to a plurality of predefined angular intervals/positions.

Examples of the disclosure may relate to devices and methods forperforming various medical procedures and/or treating portions of thelarge intestine (colon), small intestine, cecum, esophagus, any otherportion of the gastrointestinal tract, and/or any other suitable patientanatomy (collectively referred to herein as a “target treatment site”).The device and related methods may be used laparoscopically orendoscopically, or in any other open or minimally invasive procedure,including thorascopic and ENT procedures. Reference will now be made indetail to examples of the disclosure described above and illustrated inthe accompanying drawings. Wherever possible, the same reference numberswill be used throughout the drawings to refer to the same or like parts.

FIG. 1A shows a schematic depiction of an exemplary medical system 100in accordance with an example of this disclosure. The medical system 100may include a handle 110 and a medical instrument 170. In the example,the handle 110 includes an outer body 112 and an inner body 114, withthe outer body 112 having a longitudinal length and defining a lumenwhich is sized, shaped, and configured to receive the inner body 114. Asdescribed in greater detail herein, the outer body 112 is configured tomove relative to the inner body 114, and vice versa, the inner body 114is configured to move relative to the outer body 112. The inner body 114of the handle 110 has a longitudinal length, and defines a lumen whichis sized, shaped, and configured to receive the medical instrument 170.

In the example, the inner body 114 includes a rack portion having aplurality of teeth 116 extending along an exterior of the inner body114. The plurality of teeth 116 extend along at least a portion of alongitudinal length of the inner body 114 (up to an entirety of thelongitudinal length) that corresponds to a range of motion of the outerbody 112 relative to the inner body 114. Accordingly, it should beunderstood that the rack portion including the plurality of teeth 116may extend along various other suitable lengths and/or surfaces of theinner body 114 than that shown and described herein without departingfrom a scope of this disclosure. The handle 110 may further include acap cover 120, an end cap 130, and a rotation assembly 150 disposed onand/or coupled to the outer body 112. The cap cover 120 of the handle110 may be positioned at a proximal end of the outer body 112 and, whensecured thereto, is configured to enclose a lumen of the outer body 112between the cap cover 120 and the outer body 112. The end cap 130 andthe rotation assembly 150 extend from and/or are coupled to the capcover 120. As described in greater detail herein, the cap cover 120, theend cap 130, and the rotation assembly 150 of the handle 110 may havevarious suitable configurations and/or arrangements relative to oneanother and to the handle 110.

Further, the medical instrument 170 of the medical system 100 mayinclude a catheter having a sheath 172, a cannula 176, and a needle 179.The cannula 176 may be disposed within a lumen of the sheath 172, andthe needle 179 may be disposed within a lumen of the cannula 176, andmay extend at least partially outward from the tip 178 of the cannula176. In the example, a position, orientation, and/or configuration ofthe needle 179 relative to the cannula 176 is fixed such that a distalend of the needle 179 is maintained at an extended position relative tothe tip 178 of the cannula 176. The sheath 172 includes a tip 174 andhas a longitudinal length defined by the distance between the tip 174and a proximal end of the sheath 172 (not shown). The cannula 176 of themedical instrument 170 includes a tip 178 and has a longitudinal lengthdefined by the distance between the tip 178 and a proximal end of thecannula 176 (not shown). As described in greater detail herein, one ormore components of the handle 110 may be configured and operable toposition the medical instrument 170 relative to a target treatment sitewithin a patient (e.g., patient anatomy). For example, the medicalinstrument 170 may be operable to puncture a target treatment site withthe needle 179, when the needle 179 is extended distally from the tip174, as shown in FIG. 1B.

Still referring to FIG. 1A, in some examples, the medical instrument 170may be operable to facilitate access of one or more tools and/or devicesto a target treatment site with the cannula 176, including and/or inaddition to the needle 179. In this instance, upon removal of the needle179 from a lumen of the cannula 176, one or more additional tools and/ordevices may be received through a lumen of the cannula 176 and extendedoutwardly and distally therefrom via the tip 178 of the cannula 176. Insome examples, the cannula 176 may be configured and operable to deformin response to the needle 179 being at least partially retracted fromthe tip 178 of the cannula 176. Additionally and/or alternatively, inother examples the cannula 176 may be configured and operable to deformin response to the tip 178 of the cannula 176 being extended outwardlyand distally from the tip 174 of the sheath 172, or vice versa, the tip174 of the sheath 172 being extended proximally relative to the tip 178of the cannula 178).

As shown in FIG. 10 , the tip 178 of the cannula 176 may be configuredand operable to conform to a predetermined shape and/or configuration(e.g., J-shaped) when the needle 179 is omitted and/or the tip 178 isextended out from a lumen of the sheath 172. It should be appreciatedthat retraction of the needle 179 from the cannula 178, and/or extensionof the tip 178 from a lumen of the sheath 172, may remove forces appliedto the cannula 176 and restraining the tip 178 to a shape and/orconfiguration, such as, for example, a linear profile as shown in FIGS.1A-1B. As described in further detail herein, a rotation assembly of thehandle 110 may be configured and operable to control a positioning ofthe J-shaped tip 178 of the cannula 176 during a procedure.

Further, in some examples, the medical instrument 170 may be operable toelectrosurgically dilate a target treatment site with the sheath 172. Inthis instance, the sheath 172 includes an electrosurgical sheath and thetip 174 includes an electrosurgical tip. It should be understood that,in other examples, the medical instrument 170 may include various othersuitable tools, configurations, hypotubes and/or components than thoseshown and described herein. By way of illustrative example, in someexamples the medical instrument 170 may include an electrosurgical end(e.g., cystotome needle) that omits the tip 178, such as, for example,for delivering a stent during a procedure. In other examples the medicalinstrument 170 omits components configured for electrical activation.

Referring back to FIG. 1A, the handle 110 may further include a firstactuator 118 and a second actuator 119 positioned on the outer body 112.In the example, the first actuator 118 and the second actuator 119 aredisposed over the outer body 112. The first actuator 118 is securedand/or coupled to the outer body 112 and is configured to move the outerbody 112 relative to the inner body 114 in response to actuation of thefirst actuator 118. In the example, the first actuator 118 is integralwith the outer body 112 such that the first actuator 118 forms a unitarystructure with the outer body 112. Further, the second actuator 119 issecured and/or coupled to the inner body 114 and is configured to movethe inner body 114 relative to the outer body 112 in response toactuation of the second actuator 119. For instance, the second actuator119 may be coupled to the inner body 114 through the outer body 112,such as, for example, via one or more openings and/or slots (not shown)formed through the outer body 112. The first actuator 118 and the secondactuator 119 may be configured and operable in accordance with at leastsome of the teachings of U.S. application. No. [Client Ref. No.19-0411PV01, Atty. Docket No. 06530-1057-00600], entitled “MedicalDevice Locking Assemblies and Methods of Using the Same,” filed on evendate herewith, the disclosure of which is incorporated by referenceherein.

The handle 110 further includes a distal housing 160 positioned at adistal end of the inner body 114 opposite of the outer body 112. Thedistal housing 160 of the handle 110 defines a lumen that is sized,shaped, and configured to receive one or more components of the handle110 therethrough, such as, for example, at least a portion of the innerbody 120, the medical instrument 170, and the like. The distal housing160 of the handle 110 may further include a housing tip 162 and a screw(fastener) 164. In the example, the housing tip 162 includes an openingthat is sized and shaped to facilitate an exit of the medical instrument170 from a lumen of the distal housing 160 and/or the inner body 114.The screw 164 is configured to engage an exterior surface of the innerbody 114 within a lumen of the distal housing 160 to securely couple theinner body 114 to the distal housing 160. In this instance, the screw164 is movable (e.g., rotatable) relative to the distal housing 160 toselectively engage and/or disengage the inner body 114 received therein.It should be appreciated that various other suitable fastening elements,clamps, pins, and the like are also contemplated without departing froma scope of this disclosure.

The following description provides various examples of the cap cover120, the end cap 130, and the rotation assembly 150 shown and describedabove. Each of the exemplary cap covers 120, end caps 130, and/orrotation assemblies 150 noted herein may be used with the handle 110 andthe medical instrument 170 described above, and in any of the variousprocedures described herein. Accordingly, it should be understood thatany of the cap covers 120, the end caps 130, and/or the rotationassemblies 150 shown and described herein (see FIGS. 2-12 ) may bereadily incorporated into the medical system 100 detailed above andshown in FIG. 1A.

Referring now to FIG. 2 , an example of a cap cover 120A, an end cap130A, and a rotation assembly 150A is shown and described herein. In theexample, the cap cover 120A includes a body 122A defined by a distalopening 124A and a proximal opening 126A. As described further herein,the distal opening 124A of the body 122A is sized, shaped, andconfigured to at least partially receive the end cap 130A and/or therotation assembly 150A therethrough. Further, the proximal opening 126Aof the body 122A is sized, shaped, and configured to receive therotation assembly 150A therethrough. The body 122A of the cap cover 120Afurther includes a recess 125A formed along a sidewall of the body 122Abetween the distal opening 124A and the proximal opening 126A. Asdescribed further herein, the recess 125A is sized and shaped to receiveone or more components of the end cap 130A when the cap cover 120A iscoupled thereto (e.g., a pin housing 134A). The cap cover 120A mayinclude one or more slots 127A formed along one or more sidewalls of thebody 122A. The one or more slots 127A may extend along an axistransverse (e.g., substantially perpendicular) to a longitudinal axis ofthe handle 110. The cap cover 120A includes a pair of slots 127A formedthrough a pair of sidewalls of the body 122A and positioned relativelyadjacent to the proximal opening 126A.

Additionally, the cap cover 120A may include one or more apertures 128Aformed along one or more sidewalls of the body 122A. The cap cover 120Aincludes a pair of apertures 128A formed through a pair of sidewalls ofthe body 122A and positioned relatively adjacent to the distal opening124A. In the example, the pair of slots 127A and the pair of apertures128A of the cap cover 120A are formed along the same sidewalls of thebody 122A, however, it should be understood that the slots 127A and/orthe apertures 128A may be positioned along various other walls and/orsurfaces of the body 122A of the cap cover 120A without departing from ascope of this disclosure. For example, the same sidewall(s) of the body122A may include the slot 127A and the aperture 128A. It should furtherbe understood that, in other examples, the cap cover 120A may includeadditional and/or fewer slots 127A and apertures 128A than those shownand described herein.

Still referring to FIG. 2 , the end cap 130A includes a central body132A and a pin housing 134A extending radially outward from the centralbody 132A. The pin housing 134A may be transverse (e.g., substantiallyperpendicular) to a longitudinal axis of the central body 132A of theend cap 130A. As noted above, the pin housing 134A extends outwardlyfrom the body 122A of the end cap 130A through the recess 125A when theend cap 130A is coupled to the cap cover 120A. The pin housing 134A ofthe end cap 130A includes an active pin 136A disposed therein such thatthe pin housing 134A encloses the active pin (connector) 136A. In theexample, the active pin 136A may be operable to establish communicationwith the medical instrument 170 when the end cap 130A is coupled to theouter body 112 and the medical instrument 170 is disposed within theinner body 120. For example, the active pin 136A may be communicativelycouple to one or more components of the medical instrument 170, such as,for example, the sheath 172 (e.g., an electrosurgical sheath comprisingan electrically conductive material). In this instance, the active pin136A is operable to establish electrosurgical connection between thesheath 172 of the medical instrument 170 and an ancillary device, suchas, for example, an electrosurgical generator (not shown) operable togenerate high frequency electric or RF current.

The body 132A of the end cap 130A may include one or more componentsthat are configured and operable to engage corresponding components ofthe cap cover 120A to couple the end cap 130A to the cap cover 120A. Forexample, in the example, the end cap 130A may include one or moreprotrusions 138A extending outwardly from one or more sidewalls of thecentral body 132A and positioned relatively adjacent to a distal end ofthe body 132A. It should be understood that a quantity of theprotrusions 138A included on the body 132A of the end cap 130Acorresponds to a quantity of the apertures 128A included on the body122A of the cap cover 120A. In the example, the end cap 130A includes apair of protrusions 138A in accordance with the pair of apertures 128Aon the cap cover 120A. In this instance, each of the pair of protrusions138A may be sized and shaped to correspond with a size and shape of theaperture 128A such that the pair of apertures 128A are configured toreceive the pair of protrusions 138A therein, respectively, to couplethe cap cover 120A to the end cap 130A. In other examples, theprotrusions 138A may include various other suitable shapes, sizes,and/or configurations than those shown and described herein.Furthermore, additional and/or fewer protrusions 138A may be included onthe body 132A of the end cap 130A without departing from a scope of thisdisclosure.

Still referring to FIG. 2 , the end cap 130A may include one or moreledges 139A disposed along a proximal end of the body 132A. The one ormore ledges 139A may be disposed between, and defined by, one or morerecesses 137A disposed along a proximal end of the body 132A. In theexample, the end cap 130A includes recesses 137A formed and definedbetween an adjacent pair of ledges 139A. As described further herein,the ledges 139A of the end cap 130A are sized and shaped in accordancewith one or more components of the rotation assembly 150A (e.g., adistal flange 154A) to facilitate an alignment and/or engagement of therotation assembly 150A to a proximal end of the end cap 130A. The endcap 130A further includes an engagement interface 140A positioned alonga proximal end of the body 132A. As described in further detail herein,the engagement interface 140A may include one or more components thatare configured and operable to engage corresponding components of therotation assembly 150A to couple the end cap 130A to the rotationassembly 150A.

The rotation assembly 150A may include a body 152A defined by a distalflange 154A and a proximal end 151A. In the example, the body 152A ofthe rotation assembly 150A may include one or more features disposedalong an exterior of the rotation assembly 150A to facilitate a manualmanipulation of the rotation assembly 150A. By way of example only, thebody 152A of the rotation assembly 150A may include one or moreprotrusions, recesses, flanges, tabs, and like surface features forproviding ease to grasp the body 152A by a user of the medical system100. The body 152A is further sized and shaped to be received throughthe distal opening 124A and the proximal opening 126A of the cap cover120A when the rotation assembly 150A is inserted into the cap cover120A. It should be appreciated that the distal flange 154A of therotation assembly 150A is sized relatively greater than at least theproximal opening 126A to inhibit removal of the rotation assembly 150Afrom the cap cover 120A via the proximal opening 126A during use of themedical system 100.

Still referring to FIG. 2 , the distal flange 154A extends radiallyoutward from the body 152A, for example, the distal flange 154A extendsabout an outer perimeter of the body 152A. In some examples, the distalflange 154A may include one or more flat edges and/or one or more curvededges. In the example shown and described herein, the distal flange 154Aincludes a pair of flat edges each disposed between a pair of curvededges. The pair of curved edges of the distal flange 154A are sized andshaped in accordance with a size and shape of the ledges 139A of the endcap 130A. Accordingly, it should be appreciated that the distal flange154A is configured to be received by and/or between the pair of ledges139A of the end cap 130A in response to moving a distal end of therotation assembly 150A toward a proximal end of the end cap 130A. Insome examples, the one or more ledges 139A of the end cap 130A may beoperable to snap onto and/or interlock with the distal ledge 154A of therotation assembly 150A to couple the rotation assembly 150A to the endcap 130A.

It should be appreciated that the slots 127A on the body 122A of the capcover 120A and the recesses 137A on the body 132A of the end cap 130Aare sized, shaped, and configured to receive the curved edges of thedistal flange 154A when the rotation assembly 150A is received betweenand rotated relative to the cap cover 120A and the end cap 130A. Inother words, the slots 127A and the recesses 137A are operable toaccommodate the curved edges of the distal flange 154A when the rotationassembly 150A is rotated such that the curved edges 154A are alignedwith the slots 127A and the recesses 137A, respectively.

Still referring to FIG. 2 , the rotation assembly 150A further includesa distal shaft 156A extending outwardly from the distal flange 154A. Thedistal shaft 156A extends distally from the distal shaft 156A away fromthe body 152A and the proximal end 151A. The distal shaft 156A mayinclude one or more ridges 158A disposed along a longitudinal length ofthe distal shaft 156A. In the example, the distal shaft 156A includes aplurality of ridges 158A extending radially outward from an exterior ofthe distal shaft 156A. The plurality of ridges 158A of the distal shaft156A may be defined by at least one recess formed between a pair ofadjacent ridges 158A. As described in further detail herein, the ridges158A on the distal shaft 156A are configured to engage one or morecomponents of the engagement interface 140A on the end cap 130A (e.g., aflex arm 142A) to couple the rotation assembly 150A to the end cap 130Aand provide tactile feedback during use (e.g., rotation of the rotationassembly 150A). The proximal end 151A of the rotation assembly 150Aincludes a proximal opening 153A that facilitates access to a lumen ofthe rotation assembly 150A. It should be understood that a lumen of therotation assembly 150A may extend through the body 152A from theproximal opening 153A to a distal opening positioned at a terminaldistalmost end of the distal shaft 156A (see FIG. 3 ). As describedabove, a lumen of the rotation assembly 150A is sized, shaped, andconfigured to receive one or more tools and/or devices therethrough,such as, for example, the needle 179 of the medical instrument 170.

Referring now to FIG. 3 , the distal shaft 156A of the rotation assembly150A may be received in the body 132A of the end cap 130A through aproximal end of the end cap 130A. The engagement interface 140A of theend cap 130A may include one or more flex arms 142A extending from aninner circumferential surface, radially inward into a lumen of the endcap 130. The one or more flex arms 142A may be circumferentiallyadjacent to one another and offset relative to an adjacent flex arm142A. In some examples, the one or more flex arms 142A extend along anaxis that is offset from a longitudinal axis of the engagement interface140 (e.g., does not intersect a radial center of a lumen of theengagement interface 140A). In other words, the one or more flex arms142A do not extend toward a radial center of the engagement interface140A.

In the example, the engagement interface 140A includes four flex arms142A, however, it should be appreciated that in other examples, theengagement interface 140A may include additional and/or fewer flex arms142A. The flex arms 142A are configured to engage the one or more ridges158A on the distal shaft 156A of the rotation assembly 150A when therotation assembly 150A is received within the end cap 130A. In someexamples, the flex arms 142A may include an abutment feature at a distalend of the flex arm 142A that is configured and operable to engage theone or more ridges 158A of the distal shaft 158A, such as, for example,a protrusion, a rounded/circular tip, a curved surface, and the like.Accordingly, the flex arms 142A are operable to at least partiallycouple the rotation assembly 150A to the end cap 130A in response toengaging the one or more ridges 158A on the distal shaft 156A. It shouldbe appreciated that the flex arms 142A of the end cap 130A extend into alumen of the body 132A at an angular array and are flexibly deformablesuch that the flex arms 142A are configured to deform in response toreceiving a radial force applied thereto.

According to an exemplary method of using the cap cover 120A, the endcap 130A, and the rotation assembly 150A with the medical system 100during a procedure, the medical system 100 may initially be insertedinto a patient and maneuvered such that the medical instrument 170received within the handle 110 is positioned adjacent to a targettreatment site. At least the cannula 176 of the medical instrument 170is secured to the rotation assembly 150A such that rotation of therotation assembly 150A relative to the cap cover 120A, the end cap 130,and/or the handle 110 provides a rotation of the cannula 176 within alumen of the outer body 112 and the inner body 114. Thus, the rotationassembly 150A may control a radial orientation of the tip 178 of thecannula. In examples where the tip 178 includes a predetermined shapeand/or configuration, such as, for example, a J-shaped tip 178 as shownin FIG. 10 , rotation of the rotation assembly 150A provides positionaland/or directional control of the J-shaped tip 178. Accordingly, a usermay actuate the rotation assembly 150A at a proximal end of the medicalsystem 100 to rotate the cannula 176 and the tip 178 of the cannula 176near the target treatment site. With the needle 179 received within thecannula 176, it should be appreciated that actuation of the rotationassembly 150A may provide a simultaneous rotation of the needle 179 withthe cannula 176. In some examples, the needle 179 may be removed fromwithin a lumen of the cannula 176 such that actuation of the rotationassembly 150A may provide rotation of the cannula 176 and/or otherdevices/instruments disposed within the cannula 176.

With the distal shaft 156A of the rotation assembly 150A extendingthrough a lumen of the end cap 130A, the flex arms 142A of the end cap130A may flex outwardly as the distal shaft 156A of the rotationassembly 150A rotates therein. The ridges 158A on the distal shaft 156Amay abut against the flex arms 142A thereby applying an outward radialforce onto the flex arms 142A. In this instance, the ridges 158A maycause each of the flex arms 142A to bend at least partially away fromthe distal shaft 156A until becoming aligned with a recess formedbetween a pair of adjacent ridges 158A. Receipt of a portion of the flexarms 142A in the recesses on the distal shaft 156A may at leastpartially fix a radial orientation of the rotation assembly 150Arelative to the cap cover 120A, the end cap 130A, and the handle 110. Itshould be appreciated that the flex arms 142A may partially inhibitfurther rotation of the rotation assembly 150A when received within arecess on the distal shaft 156A (for example, until the rotationassembly 150A is rotated again by a user).

In the example, the rotation assembly 150A is configured to generate anindexing feedback in response to rotating the rotation assembly 150Arelative to the cap cover 120A, the end cap 130A, and/or the handle 110.For example, a user of the medical system 100 may experience a tactile,audible and/or visual feedback at the body 152A of the rotation assembly150A when the flex arms 142A of the end cap 130A are received within therecesses between an adjacent pair of ridges 158A and/or when rotatingthe rotation assembly 150A. In this instance, a user of the medicalsystem 100 may incrementally index a position (e.g., orientation) of themedical instrument 170, for example, the cannula 176 and the needle 179(when disposed within the cannula 176), relative to the handle 110 byreceiving the indexing feedback.

It should be appreciated that the recesses formed between adjacentridges 158A along the distal shaft 156A form a plurality of predefinedangular intervals that the rotation assembly 150A (and the medicalinstrument 170) may be positioned at. Accordingly, a quantity of therecesses and/or the ridges 158A included along the distal shaft 156A maydetermine a quantity of the predefined angular intervals formed by therotation assembly 150A. Further, the ridges 158A on the distal shaft156A are configured to inhibit movement of the rotation assembly 150A ateach of the plurality of predefined angular intervals by engaging theflex arms 142A with adjacent pairs of ridges 158A. The flex arms 142Amay provide a force for maintaining the rotation assembly 150A in atleast one of the predefined angular intervals. This force may beovercome to allow movement of the rotation assembly 150A and the cannula176 relative to the handle 110, by applying a rotational force onto thebody 152A greater than the force applied by the flex arms 142A.

Referring now to FIG. 4 , an example of an end cap 130B and a rotationassembly 150B is shown and described herein. It should be understoodthat the end cap 130B and the rotation assembly 150B of the example maybe incorporated with the cap cover 120A shown and described above. Itshould further be understood that, except as otherwise explicitly notedherein, the end cap 130B and the rotation assembly 150B may beconfigured and operable similar to the end cap 130A and the rotationassembly 150A described above, respectively, such that correspondingnumerals are used to identify similar features. For example, therotation assembly 150B may include a body 152B defined by a proximal end151B and a distal flange 154B, with the proximal end 151B including aproximal opening 153B that facilitates access to a lumen of the rotationassembly 150B.

It should be understood that the body 152B of the rotation assembly 150Bmay include one or more luer features, such as, for example, at and/oradjacent to the proximal opening 1538, as shown in FIG. 4 . In thisinstance, the luer feature of the rotation assembly 150B may beconfigured to allow attachment of a medical instrument (e.g., a syringe)to the proximal opening 153B of the rotation assembly 150B, therebyfacilitating fluid communication between a lumen of the rotationassembly 150B and the medical instrument. Further, the rotation assembly150B includes a distal shaft 156B extending distally from the distalflange 154B and defining at least a distal portion of the lumen of therotation assembly 150B. The rotation assembly 150B differs from therotation assembly 150A described above in that the distal flange 1548 isdefined by a single continuous curved edge extending about an outerperimeter of the body 1528.

The end cap 130B may include a body 132B having one or more alignmentfeatures 138B disposed along an exterior of the body 132B. In theexample, the end cap 130B includes a pair of alignment features 138B,however, it should be understood that the end cap 1308 may includeadditional and/or fewer alignment features 138B without departing from ascope of the disclosure. The pair of alignment features 138B areconfigured to engage a corresponding feature of one or more othercomponents of the medical device 100 to facilitate an alignment and/orengagement of the end cap 130B to the component of the medical device100, such as, for example, a rotation assembly cover (not shown)configured to enclose the rotation assembly 150A therein, the cap cover120A, and/or the like. For example, the rotation assembly cover may be acomponent of the needle 179, and the alignment features 138B mayinterface with the rotation assembly cover as a rotational stop.

Still referring to FIG. 4 , the end cap 130B may further include a ledge137B and one or more locks 139B extending about a proximal end of thebody 132B. In the example, the end cap 130B includes a pair of locks139B, with each of the locks 139B disposed circumferentially adjacentthe ledge 137B at a proximal end of the body 132B. The ledge 137B issized and shaped in accordance with a profile of the distal flange 1548of the rotation assembly 1508 such that the ledge 137B is configured toreceive the distal flange 154B therein. The pair of locks 1398 areflexibly movable relative to the ledge 137B and are configured to engagethe distal flange 154B to couple the end cap 130B to the rotationassembly 150B in response to the distal flange 154B being receivedagainst the ledge 137B. In some examples, the pair of locks 139B mayinclude a protrusion extending radially inward relative to the ledge137B such that the protrusion of the lock 1398 is operable to abutagainst the distal flange 1548 to secure the rotation assembly 1508 tothe end cap 1308.

The end cap 130B further includes an engagement interface 140B at aproximal end of the body 132B that has one or more flex arms 142Bextending inwardly into a lumen of the end cap 130B. In the example, theflex arms 142B of the engagement interface 140B are substantiallysimilar to the flex arms 142A of the engagement interface 140A on theend cap 130A shown and described above. The distal shaft 156B of therotation assembly 150B includes one or more ridges 1588 andcorresponding recesses formed between adjacent pairs of ridges 1588. Inthe example, the ridges 158B and the distal shaft 156B of the rotationassembly 150B are substantially similar to the ridges 158A and thedistal shaft 156A of the rotation assembly 150A shown and describedabove. Accordingly, the rotation assembly 150B is configured andoperable to interact with the end cap 130B as similarly described abovewith respect to the rotation assembly 150A and the end cap 120A.

Referring now to FIG. 5 , an example of a cap cover 120C, an end cap130C, and a rotation assembly 150C is shown and described herein. Itshould be understood that, except as otherwise explicitly noted herein,the cap cover 120C, the end cap 130C, and the rotation assembly 150C maybe configured and operable similar to the cap cover 120A, the end cap130A, and the rotation assembly 150A described above, respectively, suchthat corresponding numerals are used to identify similar features. Forexample, the rotation assembly 150C may include a body 152C defined by aproximal end 151C and a distal flange 154C, with the proximal end 151Cincluding a proximal opening 153C (FIG. 6 ) that facilitates access to alumen of the rotation assembly 150C. Further, the rotation assembly 150Cincludes a distal shaft 156C extending distally from the distal flange154C. The rotation assembly 150C differs from the rotation assembly 150Adescribed above in that the distal shaft 156C includes one or moreapertures 158C formed thereon. The distal shaft 156C of the rotationassembly 150C includes a plurality of apertures/recesses 158C extendingalong an annular array about an exterior of the distal shaft 156C. Itshould be appreciated that the plurality of apertures/recesses 158C maybe spaced from one another along the distal shaft 156C of the rotationassembly 150C at any suitable interval.

The cap cover 120C may include a body 122C defined by a distal opening124C and a proximal opening 126C. The distal opening 124C is sized,shaped, and configured to receive the rotation assembly 150C and the capcover 120C therethrough. The body 122C further includes a recess 128Cthat is sized and shaped to receive one or more components of the endcap 130C therethrough, such as, for example, a pin housing 134C. Thebody 122C of the cap cover 120C further includes one or more openings129C through an exterior of the body 122C into a lumen of the body 122C.As described further below, the cap cover 120C includes a pair ofopenings 129C that are each configured to receive a fastener (not shown)therethrough for coupling the cap cover 120C to another component of themedical system 100, such as, for example, the end cap 130C (FIG. 6 ).

Still referring to FIG. 5 , the end cap 130C may include a body 132Chaving a pin housing 134C extending outwardly therefrom and one or moreengagement tabs 137C extending distally from a distal end of the body132C. In the example, the end cap 130C includes a pair of engagementtabs 137C extending distally from a distal end of the body 132C, withthe engagement tabs 137C disposed about a lumen of the body 132C. Itshould be understood that the pair of engagement tabs 137C areconfigured to align and/or engage the end cap 130C to the handle 110 ofthe medical system 100. For example, the pair of engagement tabs 137Cmay be operable to engage the outer body 112 of the handle 110 tothereby couple the end cap 130C to the outer body 112.

The end cap 130C may further include one or more openings 138C, 139Cformed through an exterior of the body 132C such that the openings 138C,139C extend into a lumen of the body 132C. The end cap 130C includes apair of distal openings 138C and a pair of proximal openings 139C, withthe distal openings 138C positioned adjacent to a distal end of the body132C relative to the proximal openings 139C and the proximal openings139C positioned adjacent to a proximal end of the body 132C relative tothe distal openings 138C. As described further below, the pair of distalopenings 138C are each configured to receive a fastener (not shown)therethrough for coupling the end cap 130C to another component of themedical system 100, such as, for example, the cap cover 120C (FIG. 6 ).In the example, the end cap 130C further includes a detent 140C that issized, shaped, and configured to be received within at least one of theproximal openings 139C. As described in further detail herein, thedetent 140C is configured to engage at least one of the plurality ofrecesses 158C along the distal shaft 156C of the rotation assembly 150Cin response to the end cap 130C receiving the rotation assembly 150Ctherethrough. In some examples, the detent 140C may include a balland/or protrusion feature coupled to a distal end of a spring and/orbiasing mechanism. In this instance, the ball/protrusion at the distalend of the spring may be the portion of the detent 140C received withinthe recess 158C. In other examples, the detent 140C may include anelastic protrusion that is longitudinally expandable and compressible.

Referring now to FIG. 6 , the detent 140C is depicted within theproximal opening 139C and engaged with at least one of the plurality ofrecesses 158C. In this instance, the detent 140C at least partiallymaintains the rotation assembly 150C at a fixed radial position (e.g.,orientation) relative to the cap cover 120C, the end cap 130C, and/orthe handle 110 when received within the recess 158C. The distal flange154C of the rotation assembly 150C is disposed between, and engaged by,a proximal end of the cap cover 120C and a proximal end of the end cap130C. The distal flange 154C is received within a cavity 133C formedbetween a proximal end of the cap cover 120C and a proximal end of theend cap 130C. In this instance, the rotation assembly 150C is axiallyand longitudinally fixed relative to the cap cover 120C and the end cap130C. It should be understood that, in other examples, the end cap 130Cmay include additional detents 140C, such as, for example, within theother proximal opening 139C of the body 132C. As noted above, with thecap cover 120C disposed over the end cap 130C, the pair of openings 129Con the body 122C of the cap cover 120C may align with the pair of distalopenings 138C on the body 132C of the end cap 130C. In this instance, afastener (not shown) may be received through the corresponding openings129C, 138C to fasten the cap cover 120C to the end cap 130C.

According to an exemplary method of using the cap cover 120C, the endcap 130C, and the rotation assembly 150C with the medical system 100during a procedure, the detent 140C may engage the distal shaft 156Cwhen the rotation assembly 150C is received through a lumen of the endcap 130C. The detent 140C is biased toward the distal shaft 156C andreceived within at least one of the plurality of recesses 158C. Therotation assembly 150C is configured to move (e.g., push) the detent140C out from the recess 158C (compressing the spring of the detent140C) as the distal shaft 156C rotates within the end cap 130C. Rotationof the rotation assembly 150C may cause the detent 140C to exit therecess 158C and be received along an exterior surface (i.e. a space) ofthe distal shaft 156C disposed between a pair of adjacent recesses 158C.

In this instance, the exterior surface of the distal shaft 156C may abutagainst the detent 140C, thereby applying an outward radial force ontothe detent 140C (compressing the spring). In this instance, the rotationassembly 150C may cause the ball/protrusion of the detent 140C to moveout of the recess 158C until the ball/detent is aligned with at leastanother recess 158C along the distal shaft 156C. Receipt of the detent140C in the recess 158C on the distal shaft 156C may at least partiallyfix a radial orientation of the rotation assembly 150C relative to thecap cover 120C, the end cap 130C, and the handle 110. It should beappreciated that the recesses 158C and the detent 140C may collectivelyinhibit further rotation of the rotation assembly 150C when the detent140C is biased toward, and received within, at least one recess 158C onthe distal shaft 156C.

In the example, the rotation assembly 150C is configured to generate anindexing feedback in response to rotating the rotation assembly 150Crelative to the cap cover 120C, the end cap 130C, and/or the handle 110.For example, a user of the medical system 100 may experience a tactileand/or audible feedback at the body 152C of the rotation assembly 150Cwhen the detent 140C of the end cap 130C is received within at least oneof the apertures 158C on the distal shaft 156C and/or during rotation ofthe rotation assembly 150C. In this instance, a user of the medicalsystem 100 may incrementally index a radial position (e.g., orientation)of the medical instrument 170, for example, the cannula 176 and theneedle 179 (when disposed within the cannula 176), relative to thehandle 110 by receiving the indexing feedback.

It should be appreciated that the plurality of recesses 158C includedalong the distal shaft 156C form a plurality of predefined angularintervals that the rotation assembly 150C (and the medical instrument170) may be positioned at. Further, the plurality of recesses 158C onthe distal shaft 156C are configured to inhibit movement of the rotationassembly 150C at each of the plurality of predefined angular intervalsby engaging the detent 140C within at least one of the plurality ofrecesses 158C. The detent 140C may provide a force for maintaining therotation assembly 150C in at least one of the predefined angularintervals. This force may be overcome to allow movement of the rotationassembly 150C and the cannula 176 relative to the handle 110, byapplying a predetermined rotative force onto the body 152C greater thanthe force applied by the spring of the detent 140C.

Referring now to FIGS. 7-9 , an example of a cap cover 120D, an end cap130D, and a rotation assembly 150D is shown and described herein. Itshould be understood that, except as otherwise explicitly noted herein,the cap cover 120D, the end cap 130D, and the rotation assembly 150D maybe configured and operable similar to the cap cover 120A, the end cap130A, and the rotation assembly 150A described above, respectively, suchthat corresponding numerals are used to identify similar features. Forexample, referring to FIG. 7 , the end cap 130D may include a body 132Ddefining a lumen 139D extending between a proximal end and a distal endof the body 132D. A proximal end of the body 132D may include anengagement interface 140D having a proximally-facing ledge 142D thatextends radially inward into the lumen 139D of the body 132D. The ledge142D of the engagement interface 140D extends into the lumen 139D to anextent such that the ledge 142D at least partially defines a size (e.g.,diameter) and shape of the lumen 139D.

The engagement interface 140D may further include two or moreproximally-facing apertures/recesses 144D formed on the ledge 142D. Inthe example, the engagement interface 140D includes a plurality ofapertures/recesses 144D disposed along the ledge 142D and facing aproximal end of the end cap 130D. The plurality of apertures/recesses144D may be circumferentially spaced apart from one another along theengagement interface 140D, such that adjacent apertures/recesses 144Dare offset relative to one another at various suitable intervals. Asdescribed further herein, each of the plurality of apertures/recesses144D are sized and shaped in accordance with a size and shape of one ormore components of the rotation assembly 150D, such as, for example, aprotrusion 158D. In some examples, one or more of the plurality ofapertures/recesses 144D may include different sizes and/or shapesrelative to one another corresponding to a size and/or shape of theprotrusion 158D (e.g., a sphere, cuboid, and/or other complimentaryshapes). It should be appreciated that, in other examples, the ledge142D on the end cap 130D may include additional and/or fewerapertures/recesses 144D than those shown and described herein withoutdeparting from a scope of the disclosure.

Still referring to FIG. 7 , the end cap 130D may further include one ormore alignment features 138D disposed along an exterior surface of thebody 132D. In the example, the end cap 130D includes a pair of alignmentfeatures 138D, however, it should be understood that the end cap 130Dmay include additional and/or fewer alignment features 138D withoutdeparting from a scope of the disclosure. The pair of alignment features138D are configured to engage a corresponding feature of one or morecomponents of the medical device 100 to facilitate an alignment and/orengagement of the end cap 130D to the corresponding component, such as,for example, a rotation assembly cover (not shown), the cap cover 120D,and/or the like. For example, the rotation assembly cover may be acomponent of the needle 179, and the alignment features 138D mayinterface with the rotation assembly cover as a rotational stop.

Referring now to FIG. 8 , the rotation assembly 150D may include a body152D defined by a proximal end 151D and a distal flange 154D, with theproximal end 151D including a proximal opening 153D (see FIG. 9 ) thatfacilitates access to a lumen of the rotation assembly 150D. Further,the rotation assembly 150D includes a distal shaft 156D extendingdistally from the distal flange 154D. The rotation assembly 150D differsfrom the rotation assembly 150A described above in that the distalflange 154D includes one or more distally-facing protrusions 158D formedthereon. The distal flange 154D of the rotation assembly 150D includes apair of protrusions 158D extending outwardly from an exterior surface ofthe distal flange 154D opposite of the body 152D. It should beappreciated that, in other examples, the rotation assembly 150D mayinclude additional and/or fewer protrusions 158D along various othersuitable surfaces than those shown and described herein. In exampleswhere the rotation assembly 150D includes multiple protrusions 158D, itshould be appreciated that the protrusions 158D may be circumferentiallyspared apart from one another by a distance corresponding to an areabetween adjacent apertures/recesses 144D along the ledge 142D of theengagement interface 142D.

Referring now to FIG. 9 , and as noted above, the protrusion 158D issized, shaped, and configured to be received within the one or moreapertures/recesses 144D along the ledge 142D of the engagement interface140D when the rotation assembly 150D is received in the end cap 130D. Inthis instance, the protrusions 158D at least partially maintain therotation assembly 150D at a fixed radial position (e.g., orientation)relative to the cap cover 120D, the end cap 130D, and/or the handle 110when received within at least one of the plurality of apertures/recesses144D on the ledge 142D. The distal flange 154D is received along theledge 142D of the engagement interface 140D and engages the ledge 142Dwhen the protrusions 158D are received within the apertures/recesses144D formed thereon.

The distal flange 154D is maintained against the ledge 142D of the endcap 130D by one or more gaskets 157D disposed between an exteriorsurface of the distal flange 154D, opposite of the ledge 142D, and aninner surface of the cap cover 120D. In the example, the one or moregaskets 157D include an O-ring formed of an elastomer that is configuredto force and/or push the distal flange 154D of the rotation assembly150D against the ledge 142D of the end cap 130D when the cap cover 120Dis coupled thereto. In other words, attachment of the cap cover 120Dwith the end cap 130D may generate a force that thereby restrictsmovement of the one or more gaskets 157D (e.g., O-ring) and causes anelastic deformation of the one or more gaskets 157D to provide linearmovement of the rotation assembly 150D.

Still referring to FIG. 9 , the cap cover 120D of the example includes asingle gasket 157D, however, it should be appreciated that additionalgaskets 157D may be included between the cap cover 120D and the distalflange 154D than those shown and described herein. For example, itshould be understood that in other examples the gasket 157D may beomitted from between the cap cover 120D and the rotation assembly 150Dentirely, and/or include various other deformable or spring-like devicesthan the O-ring described herein. Further, and as described in detailbelow, the gasket 157D is operable to flexibly deform in response toreceiving a compressive force applied thereto, such as, for example, thedistal flange 154D and/or the cap cover 120D to allow the protrusions158D to disengage from the apertures/recesses 144D.

According to an exemplary method of using the cap cover 120D, the endcap 130D, and the rotation assembly 150D with the medical system 100during a procedure, the medical system 100 may initially be insertedinto a patient and maneuvered such that the medical instrument 170received within the handle 110 is positioned adjacent to a targettreatment site. With the distal shaft 156D of the rotation assembly 150Dextending through a lumen of the end cap 130D, each of the protrusions158D of the rotation assembly 150D may engage and/or be received in atleast one of the plurality of apertures/recesses 144D on the end cap130D. The protrusions 158D are biased outwardly from the distal flange154D and received within at least one of the plurality ofapertures/recesses 144D on the ledge 142D. The rotation assembly 150D isconfigured to move (e.g., rotate) the protrusions 158D out from theaperture/recess 144D as the distal shaft 156D rotates within the end cap130D.

Rotation of the rotation assembly 150D may cause the protrusions 158D toexit the apertures/recesses 144D and be received along an exteriorsurface of the ledge 142D between a pair of adjacent apertures/recesses144D. In this instance, the exterior surface of the ledge 142D may abutagainst the protrusions 158D, thereby applying a proximal force onto thedistal flange 154D of the rotation assembly 150D. In this instance, therotation assembly 150D may move proximally relative to the cap cover120D and the end cap 130D such that the distal flange 154D abuts againstthe gasket 157D disposed between the cap cover 120D and the distalflange 154D. As a result, the distal flange 154D may cause the gasket157D to compress when the pair of protrusions 158D are not receivedwithin at least one aperture/recess 144D on the ledge 142D (high energystate), until becoming aligned with at least another aperture/recess144D (low energy state). Compression of the gasket 157D positions therotation assembly 150D in a high energy state compared to a low energystate when the pair of protrusions 158D are received within at least oneaperture/recess 144D and the gasket 157D is not compressed.

Receipt of at least a portion of the pair of protrusions 158D in theapertures/recesses 144D of the engagement interface 140D may at leastpartially fix a radial orientation of the rotation assembly 150Drelative to the cap cover 120D, the end cap 130D, and the handle 110. Itshould be appreciated that the apertures/recesses 144D and theprotrusions 158D may collectively inhibit further rotation of therotation assembly 150D when the protrusions 158D are biased toward, andreceived within, at least one aperture/recess 144D on the ledge 142D. Inthis instance, the gasket 157D may expand thereby positioning therotation assembly 150D in the low energy state.

In the example, the rotation assembly 150D is configured to generate anindexing feedback in response to rotating the rotation assembly 150Drelative to the cap cover 120D, the end cap 130D, and/or the handle 110.For example, a user of the medical system 100 may experience a tactileand/or audible feedback at the body 152D of the rotation assembly 150Dwhen the protrusions 158D on the distal flange 154D are received withinat least one of the apertures/recesses 144D on the ledge 142D of the endcap 130D and/or during rotation of the rotation assembly 150D. In thisinstance, a user of the medical system 100 may incrementally index aradial position (e.g., orientation) of the medical instrument 170, forexample, the cannula 176 and the needle 179 (when disposed within thecannula 176), relative to the handle 110 by receiving the indexingfeedback.

It should be appreciated that the plurality of apertures/recesses 144Dincluded along the ledge 142D of the engagement interface 140D form aplurality of predefined angular intervals that the rotation assembly150D (and the medical instrument 170) may be positioned at. Further, theplurality of apertures/recesses 144D on the end cap 130D are configuredto inhibit movement of the rotation assembly 150D at each of theplurality of predefined angular intervals by engaging the protrusions158D within at least one of the plurality of apertures/recesses 144D.The apertures/recesses 144D and/or the protrusions 158D may collectivelyprovide a force for maintaining the rotation assembly 150D in at leastone of the predefined angular intervals. The force may be overcome, toallow movement of the rotation assembly 150D and the cannula 176relative to the handle 110, by applying a rotational force onto the body152D greater than a force applied by the apertures/recesses 144D and/orthe protrusions 158D, as generated by a compression of the gasket 157D.

Referring now to FIGS. 10-11 , an example of a rotation assembly 150E isshown and described herein. It should be understood that the rotationassembly 150E of the example may be incorporated with the cap cover 120Dand the end cap 130D shown and described above. It should further beunderstood that, except as otherwise explicitly noted herein, therotation assembly 150E may be configured and operable similar to therotation assembly 150A described above such that corresponding numeralsare used to identify similar features. For example, the rotationassembly 150E may include a body 152E defined by a proximal end 151E anda distal flange 154E, with the proximal end 151E including a proximalopening 153E (see FIG. 10 ) that facilitates access to a lumen of therotation assembly 150E. Further, the rotation assembly 150E includes adistal shaft 156E extending distally from the distal flange 154E.

The rotation assembly 150E differs from the rotation assembly 150Adescribed above in that the distal flange 154E includes one or moredetents 158E formed thereon or otherwise attached thereto. The distalflange 154E of the rotation assembly 150E includes a detent 158Eextending outwardly from an exterior surface of the distal flange 154Eopposite of the body 152E. It should be appreciated that, in otherexamples, the rotation assembly 150E may include additional detents 158Ealong various other suitable surfaces than those shown and describedherein. Further, it should be understood that, in other examples, theone or more detents 158E may be formed on one or more other componentsof the medical device 100 than the rotation assembly 150E. The detent158E of the rotation assembly 150E is biased to an extended staterelative to the exterior surface of the distal flange 154E, as shown inFIG. 10 .

The detent 158E of the rotation assembly 150E is flexibly deformablesuch that the detent 158E is configured to deform (e.g., compress) fromthe extended state to a retracted state when, for example, apredetermined force is applied thereto. In some examples, the detent158E may include a ball and/or protrusion feature coupled to a distalend of a spring and/or biasing mechanism. In this instance, theball/protrusion at the distal end of the spring may be the portion ofthe detent 158E received within the apertures/recesses 144D. In otherexamples, the detent 158E may include an elastic protrusion that islongitudinally expandable and compressible. In other examples, thedetent 158E may be a screw that is threaded into the distal flange 154Esuch that the detent 158E is configured to transition from the extendedstate to the retracted state by rotating outwardly and/or inwardlyrelative to the distal flange 154E, respectively.

Referring now to FIG. 11 , and as noted above, the detent 158E is sized,shaped, and configured to be received within the one or moreapertures/recesses 144D along the ledge 142D of the engagement interface142D when the rotation assembly 150E is received in the end cap 130D. Inthis instance, the detent 158E at least partially maintains the rotationassembly 150E at a fixed position (e.g., orientation) relative to thecap cover 120D, the end cap 130D, and/or the handle 110 when receivedwithin at least one of the plurality of apertures/recesses 144D on theledge 142D. The distal flange 154E of the rotation assembly 150E isreceived along the ledge 142D of the engagement interface 140D andengages the ledge 142D when the detent 158E is received within at leastone of the plurality of the apertures/recesses 144D formed thereon.

According to an exemplary method of using the cap cover 120D, the endcap 130D, and the rotation assembly 150E with the medical system 100during a procedure, the detent 158E may engage and/or be received in atleast one of the plurality of apertures/recesses 144D when the distalshaft 156E of the rotation assembly 150E extends through a lumen of theend cap 130D. The detent 158E is biased distally and outwardly from thedistal flange 154E and at least partially received within at least oneof the plurality of apertures/recesses 144D on the ledge 142D. In thisinstance, the aperture/recess 144D sized and shaped such that the detent158E may only partially be disposed within the aperture/recess 144D.Accordingly, the distal flange 154E is offset from the ledge 142Dthereby forming a space and/or gap between the distal flange 154E andthe ledge 142D when the detent 158E is in the extended state. Therotation assembly 150E is configured to move the detent 158E out fromthe aperture/recess 144D (compressing the spring of the detent 158E) asthe distal shaft 156E rotates within the end cap 130D.

Rotation of the rotation assembly 150E may cause the detent 158E to exitthe aperture/recess 144D and be received along an exterior surface ofthe ledge 142D between a pair of adjacent apertures/recesses 144D. Inthis instance, the detent 158E may abut against the exterior surface ofthe ledge 142D, thereby applying a longitudinal proximal force onto thedetent 158E of the rotation assembly 150E (compressing the spring). Inthis instance, the space/gap between the distal flange 154E and theledge 142D provides a spatial clearance for the detent 158E totransition from the extended state to a retracted state by compressing.It should be appreciated that movement of the rotation assembly 150Erelative to the cap cover 120D and the end cap 130D is minimal due to acompression of the detent 158E. Accordingly, the distal flange 154E isoffset from the ledge 142D of the engagement interface 140D when thedetent 158E is in the retracted state until becoming aligned with atleast another aperture/recess 144D. Receipt of at least a portion of thedetent 158E in at least one aperture 144D of the engagement interface140D may at least partially fix a radial orientation of the rotationassembly 150E relative to the cap cover 120D, the end cap 130D, and thehandle 110. It should be appreciated that the apertures 144D and thedetent 158E may collectively inhibit further rotation of the rotationassembly 150E when the detent 158E is biased toward, and receivedwithin, at least one aperture/recess 144D on the ledge 142D.

In the example, the rotation assembly 150E is configured to generate anindexing feedback in response to rotating the rotation assembly 150Erelative to the cap cover 120D, the end cap 130D, and/or the handle 110.For example, a user of the medical system 100 may experience a tactileand/or audible feedback at the body 152E of the rotation assembly 150Ewhen the detent 158E on the distal flange 154E is received within atleast one of the apertures/recesses 144D on the ledge 142D of the endcap 130D and/or during rotation of the rotation assembly 150E. In thisinstance, a user of the medical system 100 may incrementally index aradial position (e.g., orientation) of the medical instrument 170, forexample, the cannula 176 and the needle 179, relative to the handle 110by receiving the indexing feedback.

It should be appreciated that the plurality of apertures/recesses 144Dincluded along the ledge 142D of the engagement interface 140D form aplurality of predefined angular intervals that the rotation assembly150E (and the medical instrument 170) may be positioned at. Further, theplurality of apertures/recesses 144D on the end cap 130D are configuredto inhibit movement of the rotation assembly 150E at each of theplurality of predefined angular intervals by engaging the detent 158Ewithin at least one of the plurality of apertures/recesses 144D. Theapertures/recesses 144D and/or the detent 158E may provide a collectiveforce for maintaining the rotation assembly 150E in at least one of thepredefined angular intervals. The force may be overcome, to allowmovement of the rotation assembly 150E and the cannula 176 relative tothe handle 110, by applying a rotational force onto the body 152Egreater than the force applied by the apertures/recesses 144D and/or thedetent 158E.

Referring now to FIG. 12 , an example of a cap cover 120F, an end cap130F, and a rotation assembly 150F is shown and described herein. Itshould be understood that, except as otherwise explicitly noted herein,the cap cover 120F, the end cap 130F, and the rotation assembly 150F maybe configured and operable similar to the cap cover 120A, the end cap130A, and the rotation assembly 150A described above, respectively, suchthat corresponding numerals are used to identify similar features. Forexample, the rotation assembly 150F may include a body 152F defined by aproximal end 151F and a distal flange 154F, with the proximal end 151Fincluding a proximal opening 153F (FIGS. 13-14 ) that facilitates accessto a lumen of the rotation assembly 150F. Further, the rotation assembly150F includes a distal shaft 156F extending distally from the distalflange 154F.

The rotation assembly 150F differs from the rotation assembly 150Adescribed above in that the distal flange 154F includes one or moredeflectable and/or flexible arms 158F formed thereon. The distal flange154F of the rotation assembly 150F includes a pair of flexible arms 158Fextending outwardly from a perimeter edge of the distal flange 154F. Inthe example, each of the pair of flexible arms 158F is sized, shaped,and configured to be received within one or more components of the endcap 130F, such as, for example, an opening 144F. As described in furtherdetail herein, each of the pair of flexible arms 158F is configured toengage one or more components of the end cap 130F when the end cap 130Freceives the rotation assembly 150F. For example, the flexible arms 158Fare operable to engage a pair of protrusions 142F of the end cap 130F inresponse to the rotation assembly 150F being inserted into the end cap130F.

Still referring to FIG. 12 , the cap cover 120F may include a body 122Fdefined by a distal opening 124F and a proximal opening 126F. The distalopening 124F is sized, shaped, and configured to receive the rotationassembly 150F and the cap cover 120F therethrough. The body 122F furtherincludes a side window 125F and one or more apertures 128F along asidewall of the cap cover 120F. The side window 125F is sized and shapedto receive one or more components of the end cap 130F therethrough, suchas, for example, a pin housing 134F. The end cap 130F may include a body132F having a pin housing 134F extending outwardly therefrom and one ormore engagement tabs 137F extending radially outward from the body 132F.The one or more engagement tabs 137F are sized, shaped, and configuredto engage a proximal end of the outer body 112 to thereby couple the endcap 130F to the handle 110. Additionally and/or alternatively, the oneor more engagement tabs 137F may be configured to engage the one or moreapertures 128F formed along the sidewalls of the cap cover 120F tothereby couple the end cap 130F to the cap cover 120F.

The end cap 130F may further include an engagement interface 140F alonga proximal end of the end cap 130F. As noted above, the engagementinterface 140F of the end cap 130F may include one or moreproximally-facing protrusions 142F and one or more proximally-facingrecesses 144F formed thereon. It should be appreciated that theprotrusions 142F alternate with, form, and define the recesses 144F. Theengagement interface 140F includes a plurality of protrusions 142F and aplurality of recesses 144F formed along a proximal end of the body 132F,with at least one recess 144F positioned between an adjacent pair ofprotrusions 142F. As described in further detail herein, each of theplurality of recesses 144F is sized, shaped, and configured to receiveat least one flexible arm 158F of the rotation assembly 150F between anadjacent pair of protrusions 142F when the end cap 130F is coupled tothe rotation assembly 150F.

As best seen in FIG. 13 , the rotation assembly 150F includes at leastone slot 159F disposed between the distal flange 154F and each of theflexible arms 158F. The flexible arms 158F of the rotation assembly 150Fare configured to extend outwardly from the distal flange 154F relativeto a size, shape, and configuration of the at least one slot 159F. Asdescribed further herein, each of the flexible arms 158F is movablerelative to the distal flange 154F in response to an expansion and/orcompression of the slot 159F disposed therebetween. Accordingly, itshould be understood that the flexible arms 158F and/or the slots 159Fare deformable relative to the distal flange 154F and that movement ofthe flexible arms 158F may increase and/or decrease a size of the slots159F.

Referring now to FIG. 14 , the rotation assembly 150F is depicted withinthe end cap 130F with the flexible arms 158F received within at leastone of the plurality of recesses 144F. In this instance, the flexiblearms 158F at least partially maintain the rotation assembly 150F at afixed radial position (e.g., orientation) relative to the cap cover120F, the end cap 130F, and/or the handle 110 when received within therecess 144F. The distal flange 154F of the rotation assembly 150F isdisposed between, and engaged by, a proximal end of the cap cover 120Fand a proximal end of the end cap 130F. In this instance, the rotationassembly 150F is longitudinally and axially fixed relative to the capcover 120F and the end cap 130F. It should be understood that, in otherexamples, the rotation assembly 150F may include additional and/or fewerflexible arms 158F on the distal flange 154F.

According to an exemplary method of using the cap cover 120F, the endcap 130F, and the rotation assembly 150F with the medical system 100during a procedure, the flexible arms 158F of the distal flange 154F mayengage the recesses 144F along the engagement interface 140F when thedistal shaft 156F of the rotation assembly 150F is received through alumen of the end cap 130F. The flexible arms 158F are biased outwardlyfrom the distal flange 154F and received within at least one of theplurality of recesses 144F. In this instance, with each of the flexiblearms 158F disposed within at least one recess 144F, the flexible arms158F are maintained in the extended state. The rotation assembly 150F isconfigured to move the flexible arms 158F out from the recesses 144F asthe distal shaft 156F rotates within the end cap 130F.

Rotation of the rotation assembly 150F may cause the flexible arms 158Fto move radially inward and exit the recesses 144F and be aligned withat least one protrusion 142F of the engagement interface 140F. In thisinstance, the flexible arms 158F may abut against the protrusions 142F,thereby applying an inwardly radial force onto the flexible arms 158F.In this instance, the end cap 130F may cause the flexible arms 158F totransition from an extended state to a compressed state until becomingaligned with at least another recess 144F between a pair of protrusions142F. In the compressed state, the at least one slot 159F disposedbetween the distal flange 154F and each of the flexible arms 158Fdeforms in response to the flexible arms 158F moving radially inwardtoward the distal flange 154F.

Receipt of at least a portion of each of the flexible arms 158F in atleast one recess 144F may at least partially fix a radial orientation ofthe rotation assembly 150F relative to the cap cover 120F, the end cap130F, and the handle 110. It should be appreciated that the protrusions142F, the recesses 144F, and the flexible arms 158F may collectivelyinhibit further rotation of the rotation assembly 150F when the flexiblearms 158F are biased toward, and received within, at least one recess144F on the end cap 130F.

In the example, the rotation assembly 150F is configured to generate anindexing feedback in response to rotating the rotation assembly 150Frelative to the cap cover 120F, the end cap 130F, and/or the handle 110.For example, a user of the medical system 100 may experience a tactileand/or audible feedback at the body 152F of the rotation assembly 150Fwhen the flexible arms 158F on the distal flange 154F are receivedwithin at least one of the recesses 144F on the end cap 130F and/orduring rotation of the rotation assembly 150F. In this instance, a userof the medical system 100 may incrementally index a radial position(e.g., orientation) of the medical instrument 170, for example, thecannula 176 and the needle 179 (when disposed within the cannula 176),relative to the handle 110 by receiving the indexing feedback.

It should be appreciated that the plurality of recesses 144F includedalong the engagement interface 140F form a plurality of predefinedangular intervals that the rotation assembly 150F (and the medicalinstrument 170) may be positioned at. Further, the plurality of recesses144F are configured to inhibit movement of the rotation assembly 150F ateach of the plurality of predefined angular intervals by engaging theflexible arms 158F between a pair of adjacent protrusions 142F. Theprotrusions 142F, the recesses 144F, and/or the flexible arms 158F maycollectively provide a force for maintaining the rotation assembly 150Fin at least one of the predefined angular intervals. The force may beovercome, to allow movement of the rotation assembly 150F and thecannula 176 relative to the handle 110, by applying a rotational forceonto the body 152F greater than the force applied by the protrusions142F, the recesses 144F, and/or the flexible arms 158F.

Each of the aforementioned devices, assemblies, and methods may be usedto facilitate access to a target treatment site and provide enhancedcontrol of ancillary tools/devices for use at the target treatment site.By providing a medical device with a rotation assembly capable ofcontrolling a plurality of tools/devices of a medical instrument coupledto the medical device at predefined angular intervals, a user mayinteract with a target treatment site using the various tools/devices ofthe medical instrument during a procedure and receive feedback of aposition of said tools/devices. In this instance, a user may reduceoverall procedure time, increase efficiency of procedures, and/or avoidunnecessary harm to a patient's body caused by limited control of theancillary tools/devices.

It will be apparent to those skilled in the art that variousmodifications and variations may be made in the disclosed devices andmethods without departing from the scope of the disclosure. Otheraspects of the disclosure will be apparent to those skilled in the artfrom consideration of the specification and practice of the featuresdisclosed herein. It is intended that the specification and examples beconsidered as exemplary only.

1-20. (canceled)
 21. A medical device, comprising: a tool; and a handleincluding a rotation assembly, wherein the rotation assembly isconfigured to rotate the tool relative to the handle at predefinedangular intervals and inhibit movement at each of the predefined angularintervals; wherein: one of the handle or the rotation assembly includesa plurality of arms; the other of the handle or the rotation assemblyincludes a plurality of recesses configured to receive the plurality ofarms; the plurality of recesses define the predefined angular intervals;and rotational movement of the rotation assembly is inhibited when atleast one arm of the plurality of arms is engaged with a recess of theplurality of recesses.
 22. The medical device of claim 21, wherein themedical device further comprises a sheath extending from the handle,wherein the tool is disposed within the sheath, and wherein the sheathis movable relative to the sheath.
 23. The medical device of claim 21,wherein the rotation assembly maintains the tool in at least one of thepredefined angular intervals to fix the tool relative to the handle; andwherein the rotation assembly releases the tool from at least one of thepredefined angular intervals in response to a predetermined rotationalforce applied to the rotation assembly.
 24. The medical device of claim21, wherein the rotation assembly is configured to generate a firstindexing feedback as the rotation assembly rotates out of a firstpredefined angular interval, and wherein the first indexing feedback isat least one of a first tactile, audible, or visual feedback.
 25. Themedical device of claim 24, wherein the rotation assembly is configuredto generate a second indexing feedback as the rotation assembly rotatesinto a second predefined angular interval, wherein the second indexingfeedback is at least one of a second tactile, audible, or visualfeedback.
 26. The medical device of claim 21, wherein: the rotationassembly includes the plurality of arms; the handle includes theplurality of recesses; the plurality of arms of the rotation assemblyextend radially outward relative to the rotation assembly; and theplurality of recesses are proximally-facing.
 27. The medical device ofclaim 26, wherein the rotation assembly further includes at least oneslot, and wherein the at least one slot is configured to expand when atleast one arm of the plurality of arms of the rotation assembly isengaged with a recess of the plurality of recesses of the handle. 28.The medical device of claim 27, wherein the at least one slot isconfigured to compress when the rotation assembly is rotated from afirst predefined angular interval to a second predefined angularinterval.
 29. The medical device of claim 21, wherein: the handleincludes the plurality of arms; the rotation assembly includes theplurality of recesses; and the plurality of arms of the handle extendradially inward into a lumen of the handle.
 30. The medical device ofclaim 29, wherein each arm of the plurality of arms of the handle isoffset from an adjacent arm of the plurality of arms.
 31. The medicaldevice of claim 29, wherein: a distal end of the rotation assemblyincludes a distal flange, the distal flange of the rotation assemblyincludes one or more flat edges, a proximal end of the handle includesone or more ledges, the one or more ledges are configured to interlockwith the distal flange to couple the rotation assembly to the handle.32. A medical device, comprising: a tool; a handle including a rotationassembly and an end cap, wherein the end cap is configured to receivethe rotation assembly, wherein the rotation assembly is configured torotate the tool in response to rotation of the rotation assemblyrelative to the end cap, wherein: the rotation assembly is configured torotate the tool at predefined angular intervals and inhibit movement ateach of the predefined angular intervals; the end cap includes aplurality of protrusions defining a plurality of recesses; the rotationassembly includes two or more arms extending radially outward from therotation assembly; and the end cap inhibits rotational movement of therotation assembly relative to the end cap when a first arm of the two ormore arms is positioned in a first recess of the plurality of recessesand when a second arm of the two or more arms is positioned in a secondrecess of the plurality of recesses.
 33. The medical device of claim 32,wherein the rotation assembly includes at least one slot, wherein the atleast one slot is configured to deform in response to a radially-inwardmovement of at least one arm of the two or more arms.
 34. The medicaldevice of claim 32, wherein each protrusion of the plurality ofprotrusions is proximally-facing, and wherein each recess of theplurality of recesses is proximally-facing.
 35. The medical device ofclaim 32, wherein the end cap and the rotation assembly are coupled to aproximal end of the handle.
 36. The medical device of claim 32, whereinthe handle further includes a cap cover, and wherein the cap cover isconfigured to couple to the end cap.
 37. A method of rotating a toolrelative to a sheath to a plurality of predefined angular positions,comprising: rotating an assembly relative to a handle from a firstpredefined angular position to a second predefined angular position;generating a first indexing feedback at the assembly in response torotating the assembly out of the first predefined angular position; andgenerating a second indexing feedback at the assembly in response torotating the assembly into the second predefined angular position;wherein the first predefined angular position is configured to maintainthe tool at a first fixed orientation relative to the sheath, and thesecond predefined angular position is configured to maintain the tool ata second fixed orientation relative to the sheath.
 38. The method ofclaim 37, further comprising: compressing a slot of the assembly to: (1)rotate the assembly from the first predefined angular position to thesecond predefined angular position; or (2) rotate the assembly from thesecond predefined angular position to the first predefined angularposition; and expanding the slot of the assembly when the assembly is inthe first predefined angular position or the second predefined angularposition.
 39. The method of claim 37, wherein the handle includes aplurality of arms extending radially into a lumen of the handle, whereinthe lumen is configured to receive at least a portion of the assembly,wherein the assembly includes a plurality of recesses configured toreceive the plurality of arms, wherein, in the first predefined angularposition, at least one arm of the plurality of arms is configured toengage with a first recess of the plurality of recesses, and wherein, inthe second predefined angular position, the at least one arm of theplurality of arms is configured to engage with a second recess of theplurality of recesses.
 40. The method of claim 37, wherein the rotationassembly includes two or more arms extending radially outward from therotation assembly, wherein the handle includes a plurality ofprotrusions defining a plurality of recesses, wherein the plurality ofrecesses are configured to receive at least one arm of the two or morearms, wherein, in the first predefined angular position, at least onearm of the plurality of arms is configured to engage with a first recessof the plurality of recesses, and wherein, in the second predefinedangular position, the at least one arm of the plurality of arms isconfigured to engage with a second recess of the plurality of recesses